munanga risk - washington health care association · albert munanga, dbh, msn, rn, hc objectives...
TRANSCRIPT
9/26/2017
1
Customer Service as a Risk Management Model Wednesday, October 4, 2017. 8:30‐10am
Albert Munanga, DBH, MSN, RN, HC
OBJECTIVES
• Upon completion of this presentation, participants will be able to:
Recognize customer service as an effective way to risk management
Understand how data can be collected and used to stage an automated and proactive risk management process
Appreciate the need to be more deliberate when it comes to training employees and setting customer service expectations
• 29 Statistics on Medical Malpractice Payouts and Lawsuits
•Written by Molly Gamble May 03, 2013
9/26/2017
2
Medical malpractice payouts
•
1. Dollars in payouts: $3.6 billion (3.4 percent less than in 2011)2. Total payouts for medical malpractice: 12,142 (one every 43 minutes)3. Payouts resulting from judgments: 5 percent4. Payouts resulting from settlements: 93%
Top five states for medical malpractice payouts
•
1. New York: $763,088,250 2. Pennsylvania: $316,167,5003. California: $222,926,200
•4. New Jersey: $206,668,2505. Florida: $203,671,100
Severity of alleged injury in medical malpractice claims
•
1. Death: 31 percent2. Significant permanent injury: 19 percent3. Major permanent injury: 18 percent4. Quadriplegic, brain damage, lifelong care: 12 percent5. Minor permanent injury: 8 percent6. Major temporary injury: 7 percent7. Minor temporary injury: 3 percent8. Emotional injury only: 1 percent9. Insignificant injury: 0.4 percent
9/26/2017
3
Fresh in Recent Memory . . .
• . Falls in Skilled Nursing Facilities
• 2. Grab Bars not properly installed
• 3. Pressure Ulcer: Family sues because they saw an ad on TV
• 4. Wheel Chair with lose breaks
• 5. Sexual Assault from “family member”
Risks to staff
Actions on Registered Nurses & Licensed Practical Nurses Licensures
Criminal Negligence
Abuse convictions
CUSTOMER SERVICE
Good Customer Service relates to the service you and your employees provide, during and after purchase of services
Good customer service can increase customer loyalty
Customers will buy more of your services
More positive word of mouth
Less complaints
9/26/2017
4
Risk Management
Risks = Threats to the business
Risk Management is related to the; identification, classification and prioritization and management of those risks
Risk Management involves the derivation of specific safeguards to specific risk and the continuous monitoring of plans put in place
9/26/2017
5
•WHY Legal Protection Right Litigation on the rise Professional Liability
Other Factors
• Assisted Living is the fasted growing segment of elder care
• Rising acuity levels in both ALFs and SNFs
• Increasing attention from/on • DOH/DSHS making SODs public/available via the web
• ADA
• FHA
• Fire Departments
• Federal discharge and transfer laws
• Ethics vs resident rights
• All these factors mean increased risk
9/26/2017
6
•“The Stone Age did not end because they ran out of stones.”
• Sheik Ahmed Zaki Yamani
Why do clients sue
• They are upset for some reason
• We probably knew there was a problem but hoped it would not go that far
• We made mistakes
• We were misunderstood
• We miscommunicated
• Negative physical or emotional outcomes
• Financial loss
• They watch too much television
• They want to
TOP FIVE REASONS PROVIDERS GET SUED• #1. Poor communication with patients: By far the biggest issue
• #2. Poor bedside manners: Quality of relationship a provider develops with their clients is important
• #3. Delay or change sharing what the problem is:
• Some patients perceive a delay in concrete diagnosis or a change in an earlier diagnosis with a physician not knowing what they’re doing
• #4. Lack of informed consent
• When patients or their families feel as though they were not provided all available information, they are more likely to pursue a lawsuit
• #5. Erroneous documentation: Accurate and thorough documentation of a patient’s care is extremely important.
9/26/2017
7
Communication…
•"A woman, without her man, is a beast."
"A woman: without her, man is a beast."
The 7 % Rule (1971, Albert Mehrabian)
55 % comes from the the speaker's body language
38 % from the tone and music of their voice
7% from actual words
Key Risk Management Concepts
1. Risk is always present
2. Related to specific things
3. Proactive risk management is most effective
4. Continuous Assessments
9/26/2017
8
The MEAT method
• Mitigate: Reduce the risk, change the situation, alter something
• Eliminate: Change the situation completely eliminate risk
• Accept: Live with it but still watch for changes
• Transfer the risk: Allow someone else to assume• (Chris Davenport, July 2012)
How Should Businesses Respond?• Customer Service is a large part• Separate Department for larger organization• Smaller organization: A manager level person should be identified to coordinate this work• Mandatory training for all staff• Observation• Documentation• Analysis of data • Guided responses to grievances/feedback• Training at orientation and throughout the year• 24/7 operation• A program with visible features • Authority to take certain actions for lower level staff • After hours contact person at the facility or community (Some employee ignore phones)• Measured outcomes• Front Desk staff‐FBI (Front Bank of Information) • Frequent/ongoing customer satisfaction surveys
9/26/2017
9
Happy Calls
• Make that silly phone call
• Step Forward
• Write a few “happy” emails
• Write a few ”hello”, ”thank you” notes
• Share your stories with their loved ones
• Be genuine and real
• Know your residents well, simple facts
• Family care conferences, make them happen at least twice a year
• Plan this work in to your daily, weekly schedules
• Don’t go at it alone
Key Points
•Know your clients well
•Know what is most important to them
•Know who is most important to them
•Know who they’re connected to
•Use that knowledge to interact more intelligently with them
•Use that knowledge in developing training programs for the staff
9/26/2017
10
Customer Service
Involves listening
Observing
Responding
Acting
•By agents on behalf of the organizations
Daily
Morning
Evening
Night time
We must do a lot of listening everyday
Not just when managers are present
Listening must be documented
Acted upon
Discussed
Processed
Analyzed
Trended
Applied
•“The Art of listening is indispensable for the right use of the mind. It is the most gracious, the most open, and the most generous of human habits.”
• Attributed to Dr. R. Barr; St Johns’ College
9/26/2017
11
Collecting Feedback
• Grievance Forms• Suggestion Boxes• Resident association Meetings• Resident’s Council• Emails involving complaints• Phone calls involving complaints• Face to face encounters• All these avenues will help to reduce
trained hopelessness • Social Media (Facebook, Glass Door
etc.
Feedback Management Process
• Review data at your leadership meetings at least monthly
• Observe for themes and trends• Intervene accordingly
• Education
• Make contact on all clients with concerns at least 3 times
• Watch for trends by:• Shift
• Staff
• Season
• Specific issue
• Share performance results from period to period with all employees
• Resident Feedback Form• Resident’s Name ________________________ Date __________ Time _______Apt # _______• Concern reported to ____________________________• Describe the feedback or concern• ________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
•
• What resolution would you like to see?• ________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________________________
•
•
•
• OFFICE USE ONLY• Staff Member Assigned to follow up _______________________________________ Follow up Date ________________• Describe follow up action taken • ________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________________________
• Was resident satisfied with the follow up? Yes ______ No ______ (If no, make second follow up)•
• Reviewed by the Executive Director ______________________________________ Date _________________________
9/26/2017
12
Answering Phone Calls
• Educate all staff on telephone etiquette
• Employees with ESL may need additional support in this area
• Messages must be written down and passed on on a piece of paper rather that leaving a voice mail
• Transcribe phone call on grievances to the form or log book of feedback/grievances
Dealing with Grievances Via Emails
• Avoid answering email as a way to resolved issues.
• You may acknowledge receipt but invite to talk In person is best
• Avoid copying too many people
• Have someone proof read
• Emails are discoverable and may be used as evidence
• It is not very uncommon for some clients to ask in a way that incriminates you
Response Time
• ASAP to 72 hours at the latest depending on the nature of the issue at hand
• Give update if issue is taking long
• Have evening and weekend management coverage or everything comes to the Administrator/Executive Director
9/26/2017
13
Conclusion
• We have simply been talking about Relationship Management
• It includes the identification, analysis, and management of relationships with people inside and outside of your team as well as their development through feedback and coaching with communication at the center of everything.
•Questions?
THANK YOU!